Gut artritli ve romatoid artritli hastalarla asemptomatik hiperürisemili bireylerde subklinik aterosklerozun karotis dopplerle ve yüksek duyarlıklı c-reaktif protein düzeyleri ile değerlendirilmesi
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Tarih
2008
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info:eu-repo/semantics/openAccess
Özet
Çalışmamızda, hiperürisemi zemininde gelişen ve kronik inflamasyonla seyreden gut artritli olgularda subklinik ateroskleroz gelişiminin değerlendirilmesi amaçlandı. Çalışmaya Trakya Üniversitesi Tıp Fakültesi İç Hastalıkları Anabilim Dalı Romatoloji Bilim Dalı Polikliniğinde gut tanısı ile takip edilen 48 hasta ve romatoid artrit tanısı ile takip edilen 40 hasta ile Trakya Üniversitesi Tıp Fakültesi İç Hastalıkları Ana Bilim Dalı Genel Dahiliye Polikliniğine başvuran asemptomatik hiperürisemisi saptanan 29 hasta çalışmaya dahil edildi. Bilinen aterosklerotik komplikasyonu olanlar çalışmaya alınmadı. Radyoloji Ana Bilim Dalı'nda tüm olguların boyun karotis doppler ultrasonografisi ile intima media kalınlıkları ölçüldü. Nefelometrik yöntem ile hassas CRP düzeyleri çalışıldı. Gutlu olgularda asemptomatik hiperürisemililere göre intima media kalınlığı ve plak oluşumu anlamlı olarak daha fazla bulundu (sırasıyla p=0,025, p=0,02). Gutlu olgularda plak varlığı erkek cinsiyette anlamlı daha fazla bulundu (p=0,021). Ayrıca gutlu olgularda plak saptananlarda yaş ortalaması anlamlı fazla bulundu (p=0,002). Gutlu ve asemptomatik hiperürisemili olgularda romatoid artritli olgulara göre metabolik sendrom varlığı anlamlı yüksek bulundu ( tüm p'ler 0,001). Gruplar arasında hassas CRP düzeyleri açısından anlamlı farklılık saptanmadı (p=0,113). Asemptomatik hiperürisemili olgularda İMK ile yaş, hs-CRP, ESH, CRP arasında pozitif kolerasyon, HDL-kolesterol arasında negatif kolerasyon bulundu (sırasıyla p=0,005, p=0,021, p<0,001, p=0,002, p=0,029). Gutlu olgularda intima media kalınlığı ile diğer parametreler arasında anlamlı ilişki saptanmadı. Sonuç olarak çalışmamız, gutlu olgularda asemptomatik hiperürisemili olgulara göre artmış ateroskleroz varlığını göstermiştir. Gut tanısı alan hastaların aterosklerotik risk faktörleri açısından değerlendirilmesi ve saptanan risk faktörlerine karşı etkin tedavi uygulanması gerektiğini ortaya koymuştur.
In our study, we aimed to evaluate the development of subclinical atherosclerosis in patients with hyperurisemia and chronic inflammation resulting with gouty arthritis. 48 patients with gouty arthritis and 40 patients with rheumatoid arthritis diagnosed and followed up as outpatient in Trakya University Faculty of Medicine, Rheumatology Department and 29 patients with asymptomatic hyperuricemia referred from the Internal Medicine outpatient clinic were included in this study. Patients with declared atherosclerosis were excluded from the study. The intima media thicknesses of the carotid arteries of each patient were measured with Doppler ultrasonography in the Radiology Department of Trakya University Faculty of Medicine. Sensitive CRP levels were evaluated with the nephelometry method. The intima media thickness values and plaque development frequency were found to be significantly higher in the patients with gout, compared to the patients with asymptomatic hyperuricemia (p=0.025, p=0.02 respectively). The plaque formation in the patients with gout was found to be significantly higher in the male gender (p=0,021). Besides, the mean age in the patients with gout and plaque formation was significantly higher (p=0,002). The frequency of the metabolic syndrome development was found to be significantly higher in the patients with gout and asymptomatic hyperuricemia than the patients with Rheumatoid arthritis (all p's 0,001). No such significant disparity was found between the groups considering the sensitive CRP levels (p=0,113). Positive corelation was observed between the intima media thicknesses of the patients with asymptomatic hyperuricemia and age, sensitive CRP, and erythrocyte sedimentation rate, while a negative corelation was observed between HDL-cholesterol (p=0,005, p=0,021, p<0,001, p=0,002, p=0,029 respectively). No significant relation was found between the intima media thicknesses of the patients with gout and other parameters. As a result, our study has demonstrated the increased frequency of the development of atherosclerosis in patients with gout compared to the patients with asymptomatic hyperuricemia. It has manifested the necessity of further examination and treatment of the patients diagnosed as gout considering the risk factors of atherosclerosis.
In our study, we aimed to evaluate the development of subclinical atherosclerosis in patients with hyperurisemia and chronic inflammation resulting with gouty arthritis. 48 patients with gouty arthritis and 40 patients with rheumatoid arthritis diagnosed and followed up as outpatient in Trakya University Faculty of Medicine, Rheumatology Department and 29 patients with asymptomatic hyperuricemia referred from the Internal Medicine outpatient clinic were included in this study. Patients with declared atherosclerosis were excluded from the study. The intima media thicknesses of the carotid arteries of each patient were measured with Doppler ultrasonography in the Radiology Department of Trakya University Faculty of Medicine. Sensitive CRP levels were evaluated with the nephelometry method. The intima media thickness values and plaque development frequency were found to be significantly higher in the patients with gout, compared to the patients with asymptomatic hyperuricemia (p=0.025, p=0.02 respectively). The plaque formation in the patients with gout was found to be significantly higher in the male gender (p=0,021). Besides, the mean age in the patients with gout and plaque formation was significantly higher (p=0,002). The frequency of the metabolic syndrome development was found to be significantly higher in the patients with gout and asymptomatic hyperuricemia than the patients with Rheumatoid arthritis (all p's 0,001). No such significant disparity was found between the groups considering the sensitive CRP levels (p=0,113). Positive corelation was observed between the intima media thicknesses of the patients with asymptomatic hyperuricemia and age, sensitive CRP, and erythrocyte sedimentation rate, while a negative corelation was observed between HDL-cholesterol (p=0,005, p=0,021, p<0,001, p=0,002, p=0,029 respectively). No significant relation was found between the intima media thicknesses of the patients with gout and other parameters. As a result, our study has demonstrated the increased frequency of the development of atherosclerosis in patients with gout compared to the patients with asymptomatic hyperuricemia. It has manifested the necessity of further examination and treatment of the patients diagnosed as gout considering the risk factors of atherosclerosis.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Romatoloji, Rheumatology, Ateroskleroz, Atherosclerosis, Gut, Gout, Tıp Bilimleri, Hastalıklar
